Provider Demographics
NPI:1578977591
Name:DUNN, SUZANNE MARIE
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:DUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 EYE ST NW
Mailing Address - Street 2:SUITE 510
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3702
Mailing Address - Country:US
Mailing Address - Phone:571-882-9743
Mailing Address - Fax:
Practice Address - Street 1:1712 EYE ST NW
Practice Address - Street 2:SUITE 510
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:571-882-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500809871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC60279085Medicaid
DC60279093Medicaid